Most Relevant Information
Provider Data
| NPI Number: | 1003391012 |
| Provider Name: | TIFFANY FAYE VANDERZIEL MA, LPCC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/26/2018 |
| Last Updated: | 10/26/2020 |
Provider Practice Location
201 N BROAD ST STE 200
MANKATO
MN
560013569
Practice Location Phone/Fax
| Phone: | 5073351500 |
| Fax: | 5072251501 |
Provider Mailing Location
201 N BROAD ST STE 200
MANKATO
MN
560013569
Provider Mailing Phone/Fax
| Phone: | 5072251500 |
| Fax: | 5072251501 |